What took so long for community funding to arrive?

Community health care received the biggest percentage increase from this spring’s provincial budget, signalling the government’s intention to transition more of the health system into home care and other community supports.

At four per cent clearly that transition is not going to be at an overwhelming speed, the money barely enough to cover inflation, population growth and the impact of an aging population. However, compared to the base funding freeze for hospitals, this looked like one sector that at least wouldn’t be scaling back health services this year.

For much of 2012 many home care watchers were wondering if and when the money would actually arrive in the sector. Finally in recent weeks there has been a series of announcements around new funding to Community Care Access Centres (CCAC) and other community-based services agencies.

The funding will extend beyond traditional home care. The Central East LHIN, for example, has allocated $9 million in funding to the CCAC, but there is more than $2.6 million more going to other recipients, including new and expanding adult day programs in Whitby and Peterborough, increased hours for the Nurse Practitioner clinic at the Port Hope Community Centre, expanding advanced addiction and concurrent disorders treatment capacity in Scarborough and Durham, more services for individuals living with acquired brain injury and increases in assisted living for a number of communities. The November 14th CE LHIN press release noted that $1.08 million was still not earmarked.

While we’re sure the recipient providers are grateful, they may be entitled to ask what took the Ministry so long? We are nearing the end of the third quarter of the fiscal year and these budgets would now have to be spent by March 31, 2013. That’s not much time.

No sooner had the CE LHIN made the announcement, for example, a little over a week later they were figuring out how to reallocate the money that couldn’t be spent within that time frame. The Central East LHIN calculated $1.4 million would have to be reallocated from the community care budget, of which the board decided to put the money right back to the CCAC to chip away at the lengthy home care wait list. When money is reallocated by the LHIN, it also comes with strings attached, including new targets for outcomes.

Let’s also remember that the CCACs themselves do very little direct care. Most of this money will be spent on nurses, therapists and personal support workers employed by private agencies working for the CCACs. That’s another step for this funding to flow, likely more delay in the process.

Normally the end of the fiscal year brings with it reduced hours and sometimes staff cuts as these agencies cope with depleted budgets. Maybe this year will be different. Depending on the LHIN region, it could also mean agencies will be scrambling to find enough temporary staff to deal with the sudden surge in funding.

The money spigot can be turned on or off at ease, but recruiting and retaining sufficient staff is a much more complex question that deserves a little more thought in the process.

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